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作为公共卫生问题的病毒性肝炎:关于当前形势及未来方向的叙述性综述

Viral Hepatitis as a Public Health Concern: A Narrative Review About the Current Scenario and the Way Forward.

作者信息

Bhadoria Ajeet S, Khwairakpam Giten, Grover Gagandeep Singh, Pathak Vineet Kumar, Pandey Pragya, Gupta Rohit

机构信息

Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

Public Health Sciences, Treat Asia/amfAR, Bangkok, THA.

出版信息

Cureus. 2022 Feb 4;14(2):e21907. doi: 10.7759/cureus.21907. eCollection 2022 Feb.

Abstract

Viral hepatitis is one of the emerging public health problems, which urgently needs special attention. The disease has a varied presentation at the time of diagnosis, and it can progress from an accidental finding to life-threatening conditions like liver cirrhosis. It belongs to the rare group of diseases that can cause chronic inflammation inside the body, and it can have a delayed presentation. It contributes substantially to the global burden on healthcare. In terms of mortality, the burden due to viral hepatitis is similar to that of HIV and tuberculosis. It is among the major global public health challenges along with other communicable diseases, such as HIV, malaria, and tuberculosis; the major difference is that there are very limited preventive models in place for viral hepatitis, especially in developing countries like India. With limited resources for diagnosis and treatment, varied levels of presentation, and a rapidly increasing burden, it can become the next silent pandemic. In the current review, the authors aimed to compile the available global strategies for combating hepatitis, protocols available for disease surveillance, and the salient points from the national program for hepatitis control in India [National Viral Hepatitis Control Program (NVHCP)], and propose some recommendations. Ensuring a health facility equipped with a rapid diagnostic kit for screening, proper lab for the confirmation, robust Health Management Information System (HMIS) portal for the data management, and organizing regular workshops for physicians and lab technicians are some of the recommendations that we put forward.

摘要

病毒性肝炎是新出现的公共卫生问题之一,亟需特别关注。该疾病在诊断时表现多样,可从偶然发现发展为诸如肝硬化等危及生命的状况。它属于能在体内引发慢性炎症的罕见疾病类别,且可能出现延迟表现。它对全球医疗负担有重大影响。在死亡率方面,病毒性肝炎造成的负担与艾滋病毒和结核病相当。它与其他传染病(如艾滋病毒、疟疾和结核病)一样,是全球主要的公共卫生挑战之一;主要区别在于,针对病毒性肝炎的预防模式非常有限,尤其是在印度等发展中国家。由于诊断和治疗资源有限、表现程度各异且负担迅速增加,它可能成为下一场无声的大流行。在当前的综述中,作者旨在汇编全球现有的抗击肝炎策略、疾病监测可用方案以及印度国家肝炎控制计划[国家病毒性肝炎控制计划(NVHCP)]的要点,并提出一些建议。我们提出的一些建议包括确保医疗机构配备快速诊断试剂盒进行筛查、配备合适的实验室进行确诊、建立强大的健康管理信息系统(HMIS)门户进行数据管理,以及为医生和实验室技术人员定期举办研讨会。

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